WHO estimates that 50,000 -100,000 women develop obstetric fistula every year; and that there are currently 2 million women living with the condition, mainly in Asia and Sub Saharan Africa.
The national estimate in Bangladesh shows that approximately 876,000 women suffer from chronic morbidity such as vaginal fistula, recto-vaginal fistula and related physical and social disabilities. The highest incidence of chronic disease cases was recorded in Chittagong Province. Based on a prevalence of maternal morbidity study, national estimates show that more than 400,000 women live in Bangladesh with vaginal fistula. The national estimate also shows that more than 1.22 million women have urinary incontinence. More than 16,000 women have rectovaginal fistula.
Obstetric fistula is estimated to affect 1% of all women in Kenya, equivalent to 250,000 women, according to the Kenyan National Bureau of Statistics. However only 3,000 women and girls receive obstetric fistula treatment each year.
It is estimated that between 140,000 and 200,000 Ugandan women of childbearing age (14-49 years) have obstetric fistula, with an estimated 1,900 new cases every year according to the Ugandan Ministry of Health’s information for World Fistula Day 2016.
It is estimated that one out of every 50 women has fistula, but only 1,500 fistula patients have been repaired each year, which means that it will take at least 80 years to treat all cases at the current rate.
One of the worst countries for maternal health indicators in the world; where fertility rates and infant and maternal mortality rates are high; malnutrition is common, early marriage is widespread, and most deliveries are conducted at home without a skilled midwife. Women in Somalia live in a very insecure context where health care infrastructure and maternal health programs have been disrupted by conflict and limited for decades.
Health facilities tend to deteriorate, basic equipment and medicines are inadequate, and there is a shortage of trained medical personnel throughout the country. All of these factors indicate a high incidence of maternal morbidity such as obstetric fistula. Due to the nature of healthcare services provided, there is virtually no data on the prevalence of fistula, although anecdotal evidence suggests that with its limited health infrastructure, Somalia will have some of the highest prevalence rates of obstetric fistula in the world.
The Democratic Republic of the Congo
Prolonged conflict over four decades has ensured that the economic indicators place the Democratic Republic of the Congo as one of the poorest developing nations. The combination of the poor economic situation, the failing health infrastructure and the limited road systems have led to high mortality rates in the Democratic Republic of the Congo, especially amongst the most marginalized communities. Estimates of maternal mortality are very high, at 549 deaths per 100,000 live births. More than two-thirds of women are reportedly born in health facilities, with 74 per cent of births assisted by trained professionals.
It is not surprising that 24% of women begin pregnancy during their teens. Finally, growing attention has been given to the trauma of sexual violence in the war-ravaged eastern region of the Democratic Republic of the Congo, where Fistula is caused by rape as well as obstructed birth. It is likely that some of the fistula repair cases may be as a result of sexual violence as well as obstructed birth.
Repair operations for both obstetric fistula and trauma fistula.
PAC also aims to strengthen the capacity of the cardiac surgery and ease the pressure on the UHI by strengthening the cardiac facilities in other referral hospitals.
Provision of training to healthcare workers at the district level to spot the clinical signs indicating heart problems. Early detection improves health outcomes.
*Subject to need